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Hematology Center
Coagulation and Cancer

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Bleeding Patient
Reversing Coumadin
Reversing Heparin
Laboratory Tests in Hematology
Laboratory Tests In Coagulation
Aceruloplasminemia
African Iron Overload
Anemia, microcytic
Antiphospholipid Syndrome
Anemia, Microcytic, real cases
ATIII Deficiency
Atransferrinemia
Aplastic Anemia
B12 deficiency
Basophilia
Coagulation and Cancer
DIC
Essential Thrombocytosis
ENZYME DISORDERS (RBC)
Eosinophilia
Folate Deficiency
Hemoglobinoapthies
Hemoglobin S/C
Hemoglobin S/S
Hemolytic Anemia
Hemochromatosis
Hemophilia
Hemostasis
Heparins
Heparin-induced thrombocytopenia
Hypercoagulable States
Hyper-Ferritinemia
ITP
Iron Chelation
IRON DEFICIENCY
IRON OVERLOAD
IRON STUDIES
Liver and hemostasis
Megaloblastic Anemia
Monocytosis
Myleofibrosis with Myeloid Metaplasia
Neutrophil Structure
vWF
Porphyria
Phorphyrias (AIP)
Phorphyrias (AIP)
Polycythemia Vera
Prothrombin 20210A
RBC Membrane Disorders
Sickle Cell
Sideroblastic Anemias
Syndromes
TTP
Thalassemia
Thrombocytopenia, congenital
Wilson's Disease
Immunological markers
Amicar
Anagrelide
Oral Anticoagulants
Refludan

Trousseau's Syndrome
Laboratory Abnormalities in chronic DIC
Clinical manifestations

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Chronic DIC: Laboratory abnormalities
Hypofibrinogenemia ( or relative decrease in fibrinogen)
Thrombocytopenia (or relative decrease in PLT count)
Fibrinogen-fibring degradation products
Increased PT
Increased PTT
Decreased factors V, VIII, X
Poor in-vitro clot formation
Microangiopathic hemolytic anemia (occurs in ~50%)
Cryoprotein(s)

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Clinical Manifestations:
1. Thrombophlebitis
2. NBTE (Tricuspid/mitral valves)
3. Hemorhagic phenomena
4. Arterial thrombi
5. PE

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TREATMENT
IN APL:
1. Distinguish DIC from primary fibrinolysis
Use Amicar if it is primary fibrinolysis
Use heparin (low dose CI) if DIC.

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How Does It Happen?

1. Tumor cells release specific protease enzymes that can cleave & therefore activate clotting factors (i.e. Cytein protease activating Factor X)
2. Tumor cells release tissue factor
3. Tumor cells activate platelets
4. tumor:PLT aggregates can occur (vis vWF)
5. vWF interacts with laminin, tumors, & PLTS
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Coagulopathy associated with chemotherapy agents:

TTP/microangiopathic process:
mitomycin C

Cavernous Sinus Thrombosis:
L-Asparaginase

MI:
Cisplatin
Bleomycin

Veno-occlusive Disease:
Bleomycin
Mitomycin
Busulfan (POD)
High-dose Ara-C (HOD)
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